李景越. 2011-2019年河南省南阳市112例儿童艾滋病抗病毒治疗效果分析[J]. 疾病监测, 2020, 35(9): 815-818. DOI: 10.3784/j.issn.1003-9961.2020.09.010
引用本文: 李景越. 2011-2019年河南省南阳市112例儿童艾滋病抗病毒治疗效果分析[J]. 疾病监测, 2020, 35(9): 815-818. DOI: 10.3784/j.issn.1003-9961.2020.09.010
Jingyue Li. Effects of antiviral therapy in 112 child AIDS cases in Nanyang, Henan[J]. Disease Surveillance, 2020, 35(9): 815-818. DOI: 10.3784/j.issn.1003-9961.2020.09.010
Citation: Jingyue Li. Effects of antiviral therapy in 112 child AIDS cases in Nanyang, Henan[J]. Disease Surveillance, 2020, 35(9): 815-818. DOI: 10.3784/j.issn.1003-9961.2020.09.010

2011-2019年河南省南阳市112例儿童艾滋病抗病毒治疗效果分析

Effects of antiviral therapy in 112 child AIDS cases in Nanyang, Henan

  • 摘要:
    目的 观察河南省南阳市儿童接受艾滋病抗病毒治疗的效果,为儿童艾滋病规范治疗和管理提供依据。
    方法 采用回顾性队列研究方法,对南阳市2011 — 2019年艾滋病综合防治信息系统纳入治疗儿童病例的主要流行病学特征、治疗、实验室检测及死亡等信息进行描述性分析,评价抗病毒治疗效果。
    结果 112例病例中,死亡26例,从治疗到观察终点中位数观察时间为4.83(1.67~6.86)年,患者开始治疗时年龄(7.12±3.54)岁;CD4+T淋巴细胞(CD4)计数治疗后第1、3和5年显著高于治疗基线,差异有统计学意义(P<0.01),但治疗超过5年后CD4计数有下降趋势,与基线比较差异无统计学意义(P>0.05);病毒载量抑制比例在治疗后第1、3、5、7和9年分别达到90.53%、90.80%、84.15%、75.95%和67.50%,第5年后病毒抑制比例呈下降趋势,第7年和第9年与第1年相比差异有统计学意义(P<0.05);患者的死亡原因依次是艾滋病相关疾病21例(80.77%),意外死亡5例(19.23%),死亡病例中从确认距离死亡的时间为(2.68±2.46)年,在治疗1年内的死亡比例为46.75/100人年。
    结论 南阳市儿童艾滋病患者发现晚的问题较为突出,治疗早期的死亡率较高,抗病毒治疗超过5年后病毒学和免疫学效果有下降趋势。应该采取措施早发现、早治疗,并提高患者治疗的远期效果。

     

    Abstract:
    Objective To understand the effects of antiviral therapy in children with AIDS in Nanyang, Henan province, and provide evidence for the standard treatment and management of AIDS in children.
    Methods A retrospective cohort study method was used to conduct a descriptive analysis on the main epidemiological characteristics, treatments, laboratory tests, and deaths of child AIDS cases included in the AIDS comprehensive prevention and treatment information system in Nanyang from 2011 to 2019 and evaluate the effects of antiviral therapy.
    Results In 112 child AIDS cases, 26 were fatal. The median of time from the beginning of the treatment to the observation end was 4.83 (1.67 to 6.86) years. The average age of cases at the beginning of treatment was (7.12±3.54) years. The CD4T lymphocyte count of 1 year, 3 years and 5 years after treatment were significantly higher than the treatment baseline, the difference was significant (P<0.01), but the CD4 count showed a downward trend after more than 5 years of treatment, and there was no significant difference compared with the baseline (P>0.05). The viral load suppression ratios were 90.53%, 90.80%, 84.15%, 75.95%, and 67.50% in the 1st, 3rd, 5th, 7th, and 9th years after treatment, respectively, showing a downward trend, and the difference in viral load suppression ratio was significant between the 7th or 9th years and the 1st year (P<0.05). The causes of the deaths were as follows: AIDS-related disease (21 cases, 80.77%), and accidental death (5 cases, 19.23%). The average interval between diagnosis and death was (2.68 ± 2.46) years, and the death rate within 1 year of treatment was 46.75/100 person year.
    Conclusion Late diagnosis of AIDS in children was a prominent problem in Nanyang, and the mortality in the early stage of treatment was high. After more than 5 years of antiviral therapy, the virological and immunological effects had downward trends. Measures should be taken for the early detection and early treatment of HIV/AIDS in children.

     

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